Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005-2006.
OBJECTIVE
Impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are considered to constitute "pre-diabetes." We estimated the prevalence of IFG, IGT, and pre-diabetes among U.S. adolescents using data from a nationally representative sample.


METHODS
We analyzed data from participants aged 12-19 years in the National Health and Nutrition Examination Survey 2005-2006. We used fasting plasma glucose and 2-h glucose during an oral glucose tolerance test to assess the prevalence of IFG, IGT, and pre-diabetes and used the log-binomial model to estimate the prevalence ratios (PRs) and 95% CIs.


RESULTS
The unadjusted prevalences of IFG, IGT, and pre-diabetes were 13.1, 3.4, and 16.1%, respectively. Boys had a 2.4-fold higher prevalence of pre-diabetes than girls (95% CI 1.3-4.3). Non-Hispanic blacks had a lower rate than non-Hispanic whites (PR 0.6, 95% CI 0.4-0.9). Adolescents aged 16-19 years had a lower rate than those aged 12-15 years (0.6, 0.4-0.9). Overweight adolescents had a 2.6-fold higher rate than those with normal weight (1.3-5.1). Adolescents with two or more cardiometabolic risk factors had a 2.7-fold higher rate than those with none (1.5-4.8). Adolescents with hyperinsulinemia had a fourfold higher prevalence (2.2-7.4) than those without. Neither overweight nor number of cardiometabolic risk factors was significantly associated with pre-diabetes after adjustment for hyperinsulinemia.


CONCLUSIONS
Pre-diabetes was highly prevalent among adolescents. Hyperinsulinemia was independently associated with pre-diabetes and may account for the association of overweight and clustering of cardiometabolic risk factors with pre-diabetes.
Li
Chaoyang
C
Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. cli@cdc.gov
Ford
Earl S
ES
Zhao
Guixiang
G
Mokdad
Ali H
AH
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D002648:Child; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology*; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D006946:Hyperinsulinism / Q000453:epidemiology*; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology; D009749:Nutrition Surveys; D011236:Prediabetic State / Q000453:epidemiology*; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors; D012727:Sex Characteristics; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D001786:Blood Glucose